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Marshall L. Stoller - One of the best experts on this subject based on the ideXlab platform.

  • determinants of Nephrostomy Tube dislodgment after percutaneous nephrolithotomy
    Journal of Endourology, 2015
    Co-Authors: David Bayne, Lindsay A. Hampson, Eric Taylor, Marshall L. Stoller
    Abstract:

    Abstract Background and Purpose: Percutaneous nephrolithotomy (PCNL) traditionally necessitates the placement of a Nephrostomy Tube at the conclusion of the surgical procedure. Although Tubeless PCNL has become more popular, patients with complex problems still need traditional Nephrostomy Tube drainage. The goal of this study was to investigate whether patient body mass index (BMI) impacted inadvertent Nephrostomy Tube dislodgement. Furthermore, we hoped to determine whether Nephrostomy Tube type impacted Tube dislodgement rates. Methods: A retrospective review between 2005 and 2012 of 475 consecutive PCNL cases was undertaken. Patients were categorized based on the type of Nephrostomy Tube placed. BMI was examined as a continuous variable. The primary outcome of Nephrostomy Tube dislodgment was determined based on imaging obtained at the time of PCNL and postoperative hospitalization. Logistic regression analysis was then used to adjust for Nephrostomy Tube type and BMI. Results: Overall, 24 (5.5%) tota...

  • Entrapped Malecot Nephrostomy Tube: etiology and management.
    The Journal of Urology, 1995
    Co-Authors: Joseph I. Sardina, Damien M Bolton, Marshall L. Stoller
    Abstract:

    AbstractNephrostomy Tubes occasionally are resistant to extraction. During the last 7 years 3 such patients with entrapped Malecot Nephrostomy Tubes have been treated successfully at our university. The entrapped Nephrostomy Tubes were removed by endoscopically incising an anchoring tissue bridge that had grown over a flange. A small endoscope was easily advanced through the lumen of the entrapped catheter to allow for adequate visualization and electrocautery of the anchoring tissue bridge. With this method an entrapped Malecot Nephrostomy Tube may be removed intact without significant injury to the renal parenchyma. Malecot Nephrostomy Tubes should be used with caution for long-term drainage of small intrarenal pelves.

  • Urologist directed percutaneous Nephrostomy Tube placement
    Journal of Urology, 1994
    Co-Authors: K. G. Mahaffey, D M Bolton, Marshall L. Stoller
    Abstract:

    A retrospective analysis of 100 consecutive ultrasonically guided percutaneous Nephrostomy Tubes placed under the guidance of urologists was done. Complications related to Tube insertion included sepsis in 3% of the cases, renal pelvic perforations in 2% and hemorrhage in 1%. There were no deaths and no need for open surgical intervention to manage these complications. An additional 21% of the Tubes malfunctioned more than 24 hours after insertion, including dislodgement in 11%, occlusion in 6%, hemorrhage in 1%, peritubular leakage in 1%, puncture site infection in 1% and severe incrustation in 1%. These delayed complications were independent of Tube type. Nephrostomy Tubes may be placed safely by urologists. Urologists usually direct the need for percutaneous Nephrostomy Tube placement and use these ports for endourological manipulations and, therefore, they should have a greater role in catheter insertion.

Janghuang Shen - One of the best experts on this subject based on the ideXlab platform.

  • Nephrostomy Tube free percutaneous nephrolithotomy for patients with large stones and staghorn stones
    Urology, 2006
    Co-Authors: Mingchin Cheng, Piche Chen, Janghuang Shen
    Abstract:

    Abstract Objectives To perform a retrospective study to assess the outcome and safety of 64 Nephrostomy Tube-free percutaneous nephrolithotomies (PCNLs) in 62 patients with calculi 3 cm or greater. Methods Between March 2001 and June 2004, 365 consecutive patients underwent 389 PCNLs at our hospital. Electrocauterization of the access tract was performed at the end of the operation in every patient. No Nephrostomy Tube was inserted in the patient if a bloodless tract had been obtained. Of the 389 PCNLs, 154 were performed in patients with a stone size of 3 cm or greater. Of these 154 PCNLs, 64 were performed with the Nephrostomy Tube-free modification (group 1) and 90 were performed with insertion of the Nephrostomy Tube after the operation (group 2). The hospital course and complications were evaluated in both groups. Results No statistically significant differences in age, stone size, urinary tract infection rate, or blood transfusion rate were found between those with and without insertion of the Nephrostomy Tube. Fourteen patients in group 1 had complete staghorn stones. A shorter operative time, lower analgesic requirement, and shorter postoperative hospital stay were noted in the group with the Nephrostomy Tube-free modification (group 1). Conclusions With adequate homeostasis, Nephrostomy Tube-free PCNL can be performed in patients with complicated urolithiasis without any increase in morbidity.

Mingchin Cheng - One of the best experts on this subject based on the ideXlab platform.

  • Nephrostomy Tube free percutaneous nephrolithotomy for patients with large stones and staghorn stones
    Urology, 2006
    Co-Authors: Mingchin Cheng, Piche Chen, Janghuang Shen
    Abstract:

    Abstract Objectives To perform a retrospective study to assess the outcome and safety of 64 Nephrostomy Tube-free percutaneous nephrolithotomies (PCNLs) in 62 patients with calculi 3 cm or greater. Methods Between March 2001 and June 2004, 365 consecutive patients underwent 389 PCNLs at our hospital. Electrocauterization of the access tract was performed at the end of the operation in every patient. No Nephrostomy Tube was inserted in the patient if a bloodless tract had been obtained. Of the 389 PCNLs, 154 were performed in patients with a stone size of 3 cm or greater. Of these 154 PCNLs, 64 were performed with the Nephrostomy Tube-free modification (group 1) and 90 were performed with insertion of the Nephrostomy Tube after the operation (group 2). The hospital course and complications were evaluated in both groups. Results No statistically significant differences in age, stone size, urinary tract infection rate, or blood transfusion rate were found between those with and without insertion of the Nephrostomy Tube. Fourteen patients in group 1 had complete staghorn stones. A shorter operative time, lower analgesic requirement, and shorter postoperative hospital stay were noted in the group with the Nephrostomy Tube-free modification (group 1). Conclusions With adequate homeostasis, Nephrostomy Tube-free PCNL can be performed in patients with complicated urolithiasis without any increase in morbidity.

  • cauterization of access tract for Nephrostomy Tube free percutaneous nephrolithotomy
    Journal of Endourology, 2004
    Co-Authors: Mingchin Cheng, Janghuang Sheen, Piche Chen
    Abstract:

    Background and Purpose: Percutaneous nephrolithotomy (PCNL) is now a popular method for removal of renal and ureteral stones. Placement of a Nephrostomy Tube after the completion of PCNL has been considered a standard procedure by most urologists, but some authors have recently challenged this practice. Bleeding is one of the most prevalent problems after Nephrostomy Tube-free percutaneous renal surgery. To diminish the possibility of postoperative bleeding, we cauterized the PCNL tract to make it bloodless. The efficacy and safety of this procedure were reviewed in this study. Patients and Methods: From March 2001 to March 2003, 51 patients underwent PCNL with a one-stage procedure and a single access tract. The stone size ranged from 1.0 to 7.0 cm (mean 2.7 ± 1.4 cm). A holmium:YAG laser and pneumatic lithotripter were used. After stone extraction, a 6F double-J catheter was inserted antegrade. The access tract was checked, and the bleeding points were cauterized. No Nephrostomy Tube was inserted, but a...

K. G. Mahaffey - One of the best experts on this subject based on the ideXlab platform.

  • Urologist directed percutaneous Nephrostomy Tube placement
    Journal of Urology, 1994
    Co-Authors: K. G. Mahaffey, D M Bolton, Marshall L. Stoller
    Abstract:

    A retrospective analysis of 100 consecutive ultrasonically guided percutaneous Nephrostomy Tubes placed under the guidance of urologists was done. Complications related to Tube insertion included sepsis in 3% of the cases, renal pelvic perforations in 2% and hemorrhage in 1%. There were no deaths and no need for open surgical intervention to manage these complications. An additional 21% of the Tubes malfunctioned more than 24 hours after insertion, including dislodgement in 11%, occlusion in 6%, hemorrhage in 1%, peritubular leakage in 1%, puncture site infection in 1% and severe incrustation in 1%. These delayed complications were independent of Tube type. Nephrostomy Tubes may be placed safely by urologists. Urologists usually direct the need for percutaneous Nephrostomy Tube placement and use these ports for endourological manipulations and, therefore, they should have a greater role in catheter insertion.

Jean J.m.c.h. De La Rosette - One of the best experts on this subject based on the ideXlab platform.

  • Nephrostomy in percutaneous nephrolithotomy pcnl does Nephrostomy Tube size matter results from the global pcnl study from the clinical research office endourology society
    World Journal of Urology, 2013
    Co-Authors: Luigi Cormio, Glenn M. Preminger, Christian Saussine, Niels Peter Buchholz, Xiaochun Zhang, Helena Walfridsson, Andreas J. Gross, Jean J.m.c.h. De La Rosette
    Abstract:

    To explore the relationships between Nephrostomy Tube (NT) size and outcome of percutaneous nephrolithotomy (PCNL). The Clinical Research Office of the Endourological Society (CROES) prospectively collected data from consecutive patients treated with PCNL over a 1-year period at 96 participating centers worldwide. This report focuses on the 3,968 patients who received a NT of known size. Preoperative, surgical procedure and outcome data were analyzed according to NT size, dividing patients into two groups, namely small-bore (SB; Nephrostomy size ≤ 18 Fr) and large-bore (LB; Nephrostomy size > 18 Fr) NT. Patients who received a LB NT had a significantly lower rate of hemoglobin reduction (3.0 vs. 4.3 g/dL; P < 0.001), overall complications (15.8 vs. 21.4 %; P < 0.001) and a trend toward a lower rate of fever (9.1 vs. 10.7 %). Patients receiving a LB NT conversely had a statistically, though not clinically significant, longer postoperative hospital stay (4.4 vs. 4.2 days; P = 0.027). There were no differences in urinary leakage (0.9 vs. 1.3 %, P = 0.215) or stone-free rates (79.5 vs. 78.1 %, P = 0.281) between the two groups. LB NTs seem to reduce bleeding and overall complication rate. These findings would suggest that if a NT has to be placed, it should better be a LB one.

  • Nephrostomy in percutaneous nephrolithotomy (PCNL): does Nephrostomy Tube size matter? Results from The Global PCNL Study from The Clinical Research Office Endourology Society
    World Journal of Urology, 2012
    Co-Authors: Luigi Cormio, Glenn M. Preminger, Christian Saussine, Niels Peter Buchholz, Xiaochun Zhang, Helena Walfridsson, Andreas J. Gross, Jean J.m.c.h. De La Rosette
    Abstract:

    To explore the relationships between Nephrostomy Tube (NT) size and outcome of percutaneous nephrolithotomy (PCNL). The Clinical Research Office of the Endourological Society (CROES) prospectively collected data from consecutive patients treated with PCNL over a 1-year period at 96 participating centers worldwide. This report focuses on the 3,968 patients who received a NT of known size. Preoperative, surgical procedure and outcome data were analyzed according to NT size, dividing patients into two groups, namely small-bore (SB; Nephrostomy size ≤ 18 Fr) and large-bore (LB; Nephrostomy size > 18 Fr) NT. Patients who received a LB NT had a significantly lower rate of hemoglobin reduction (3.0 vs. 4.3 g/dL; P